Liu Peng, Liu Lunxin, Zhang Changwei, Lin Sen, Wang Ting, Xie Xiaodong, Zhou Liangxue, Wang Chaohua
Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China.
Front Neurol. 2022 Jun 13;13:882108. doi: 10.3389/fneur.2022.882108. eCollection 2022.
Blood blister aneurysm (BBA) is a complex and rare aneurysm that presents significant treatment challenges. The application of pipeline embolization device (PED)-assisted coiling in the treatment of ruptured BBA remains controversial. This study aimed to report on our experience and assess the safety and efficacy of this strategy.
Between February 2019 and February 2021, 12 patients with ruptured BBAs underwent PED-assisted coil embolization. We collected detailed data about each patient, including demographic information, aneurysmal data, technical details, antiplatelet strategy, operation-related complications, and follow-up outcomes.
A total of 12 BBA patients were treated with single PED-assisted coil embolization. One patient experienced intraoperative rupture that was controlled by rapid coiling without clinical consequences. All the patients demonstrated complete occlusion on postoperative angiography. A total of three patients had postoperative complications: left hemiparesis, Broca's aphasia, and right hemiplegia due to vasospasm, and transient hemiparesis. Follow-up angiography revealed that all BBAs were completely occluded, except one with neck residue. All patients had favorable outcomes at discharge and the most recent clinical follow-up (mRS score ≤ 2).
Endovascular treatment of BBAs of the internal carotid artery using PED-assisted coil embolization is a safe and effective strategy. This has contributed to the understanding of BBA therapy and provides a potentially optimal treatment option for this intractable lesion.
血泡样动脉瘤（BBA）是一种复杂且罕见的动脉瘤，带来了重大的治疗挑战。管道栓塞装置（PED）辅助弹簧圈栓塞术在破裂性BBA治疗中的应用仍存在争议。本研究旨在报告我们的经验并评估该策略的安全性和有效性。
2019年2月至2021年2月期间，12例破裂性BBA患者接受了PED辅助弹簧圈栓塞术。我们收集了每位患者的详细数据，包括人口统计学信息、动脉瘤数据、技术细节、抗血小板策略、手术相关并发症及随访结果。
共12例BBA患者接受了单枚PED辅助弹簧圈栓塞治疗。1例患者术中发生破裂，通过快速弹簧圈栓塞得以控制，未产生临床后果。所有患者术后血管造影显示完全闭塞。共有3例患者出现术后并发症：因血管痉挛导致左侧偏瘫、布罗卡失语症和右侧偏瘫，以及短暂性偏瘫。随访血管造影显示，除1例有颈部残留外，所有BBA均完全闭塞。所有患者出院时及最近一次临床随访时预后良好（改良Rankin量表评分≤2分）。
采用PED辅助弹簧圈栓塞术对颈内动脉BBA进行血管内治疗是一种安全有效的策略。这有助于加深对BBA治疗的理解，并为这种难治性病变提供了一种潜在的最佳治疗选择。
